The long-term objective of the applicant, Carol M. Greco, Ph.D., is to become an independent clinical investigator in rheumatic disease, with a specialized focus on biopsychosocial influences in systemic lupus erythematosus (SLE). The candidate is a research assistant professor of Family Medicine, Anesthesiology. and Rehabilitation Science and Technology, University of Pittsburgh School of Medicine, and a licensed clinical psychologist. Dr. Greco's training objectives are to expand her knowledge base in biomedical and clinical aspects of rheumatologic diseases and biostatistics, and strengthen her skills in cardiovascular behavioral medicine, psychophysiologic assessment, and psychoneuroimmunology. Mentors Susan Manzi, MD, MPH, Karen Matthews, Ph.D., and Andrew Baum, Ph.D. have well-established research and training centers at the University of Pittsburgh, including the newly established Lupus Center of Excellence, the Pittsburgh Mind-Body Center, and programs in Cardiovascular Behavioral Medicine and Behavioral Medicine in Oncology. A program of medical, epidemiology, psychology and biostatistics coursework, and seminars, lectures, and precepted training will be implemented to accomplish the candidate's training objectives. Dr. Greco will meet regularly with her mentors and collaborators to successfully apply the developed skills in ongoing and newly initiated research programs. Her proposed research project is an outgrowth of two funded parent projects of Dr. Manzi and Dr. Joseph Ahearn (collaborator), and is aimed at investigating the role of psychosocial factors in SLE disease activity flares and in cardiovascular disease in SLE. Specifically, Dr. Greco intends to determine whether psychosocial factors (1) influence fluctuation in SLE disease activity. and (2) increase dsk of subclinical and clinical vascular disease in SLE. Results are expected to lead to studies of the impact of acute stressors on cardiovascular function and immune system parameters in SLE, and ultimately to the development of behavioral interventions to improve health and reduce SLE symptoms.